Surgery 4.0: the natural culmination of the industrial revolution?

The topic of this issue of Innovative Surgical Sciences (ISS) is “Surgery 4.0”. The term and its meaning are as yet unfamiliar to most surgeons. It was, to our knowledge, coined in 2016 [1] and was used to describe a vital development in surgery, which could conceivably become as disruptive as the current trend toward economic and industrial digitalization. To make the parallels and contrasts more evident, a reflection on the Fourth Industrial Revolution is helpful. The global economy is assumed to move forward to the Fourth Industrial Revolution. Commonly, the mechanization of production using water and steam power is considered to have driven the First Industrial Revolution. The next “revolutionary” impact on industrial productivity came from mass production facilitated by the availability of electrical energy and improved workflow organization (assembly line, etc.). This was followed by the Third Industrial Revolution, which is characterized by the use of information technology (IT) and robots to automate production. Today, a systematic transformation of industrial production is under way, which can be grossly defined as the comprehensive computerization of manufacturing (Figure 1). Open in a separate window Figure 1: Industry 4.0 attempts to describe the transformation process of industrial production from passive automated production to an active, cognitive support of the production process.